Presentation

The symptoms of a gastrinoma are directly attributable to the release of gastrin. The majority of patients have peptic ulcer disease and its attendant symptoms of abdominal pain. Additionally, patients with a gastrinoma will often have complaints of diarrhea. In fact, some degree of diarrhea is present in approximately one-half of patients. Up to 10% of patients may have diarrhea as their only presenting symptom. Symptoms of gastroesophageal reflux may also be elicited in about one-half of patients.

Gastrinomas are sporadic in approximately 75% of cases. In the other 25% of cases, however, gastrinoma occurs in association with multiple endocrine neoplasia syndrome (MEN). Specifically, it is associated with MEN I syndrome which features pituitary neoplasia and parathyroid hyperplasia in addition to a pancreatic endocrine neoplasm. Approximately 50% of gastrinomas are malignant.

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